PPQ-WB115CBluetooth Module

Lite-On Technology Corp. FCC ID.: PPQ-WB115C 4F,90,Chien 1 Road,Chung-Ho,Taipei Hsien 235,Taiwan,R.O.C. Tel : 886-2-2222-6181 Lite-On Technology Corp. 4F,90,Chien 1 Road,Chung-Ho,Taipei Hsien 235,Taiwan,R.O.C. Tel : 886-2-2222-6181 Fax: 886-2-2226-6749 Federal Communications Commission Aug. 20, 2013 Authorization and Evaluation Division Confidentiality Request Pursuant to Sections 0.457 and 0.459 of the Commission’s Rules, the Applicant Hereby requests confidential treatment of information accompanying this Application As outlined below: Schematics: (WB115C) Schem Block Diagram: (WB115C) BlkDia Operational Description : (WB115C) OPDes The above materials contain trade secrets and proprietary information not customarily Released to the public. The public disclosure of these matters might be harmful to the Applicant and provide unjustified benefits to its competitors. The Applicant understands that pursuant to Rule 0.457, disclosure of this Application and all accompanying documentation will not be made before the date of the Grant for this application. Sincerely, -------------------------------------------- TC Wu / Deputy Director(R & D Division) Lite-On Technology Corp.

RF_160, Issue 03 Declaration of Authorization We Name: Lite-On Technology Corp. Address: 4F, 90, Chien 1 Road, Chung Ho, New Taipei City 235, Taiwan, R.O.C.City: New Taipei  . Country: Taiwan, R.O.C  . Declare that: Name Representative of agent: Gene Chang (1) Agent Company name: QuieTek Corp. Address: Fl.2, No.345, Xin-hu 2 nd Rd., Nei-hu District City: Taipei Country Taiwan is authorized to apply for Certification of the following product(s): Product description: Bluetooth Module FCC ID: PPQ-WB115C Trademark: LITE-ON on our behalf. Date:  2013/08/20  .. City:  Taipei Hsien  .. Name:  TC Wu  .. (2) Function: ............Deputy Director(R & D Division)................... Signature: Notes: (1): Required for FCC application (2): For FCC it must be the Grantee Code “owner” or the authorized agent.

Lite-On Technology Corp. FCC ID.: PPQ-WB115C 4F,90,Chien 1 Road,Chung-Ho,Taipei Hsien 235,Taiwan,R.O.C..Tel : 886-2-2222-6181 Federal Communications Commission Aug. 20, 2013 Authorization and Evaluation Division ATTESTATION FCC ID: PPQ-WB115C Product: Bluetooth Module Model: WB115C We don't provide any controls or software to allow operation outside the USA frequency band when we sell this product in USA. Sincerely, ------------------------------------------ TC Wu / Deputy Director(R & D Division) Lite-On Technology Corp.

RF_734_00, Issue 1 Modular Approval Request FCC (per DA 00-1407) FCC ID: PPQ-WB115C Items to be covered Answer from applicant 1. The modular transmitter must have its own RF shielding. Please review external photos. 2. The modular transmitter must have buffered modulation/data inputs (if such inputs are provided) to ensure that the module will comply with Part 15 requirements under conditions of excessive data rates or over-modulation. The buffered integrated in chip CSR8311-A08. (Chip_U2). 3. The modular transmitter must have its own power supply regulation. The buffered integrated in chip CSR8311-A08. (Chip_U2). 4. The modular transmitter must comply with the antenna requirements of Section 15.203 and 15.204(c). The antenna must either be permanently attached or employ a “unique” antenna coupler (at all connections between the module and the antenna, including the cable).. Please review external photos or test report. 5. The modular transmitter must be tested in a stand-alone configuration, i.e., the module must not be inside another device during testing. This is intended to demonstrate that the module is capable of complying with Part 15 emission limits regardless of the device into which it is eventually installed. Please review test setup photos. 6. The modular transmitter must be labeled with its own FCC ID number, and, if the FCC ID is not visible when the module is installed inside another device, then the outside of the device into which the module is installed must also display a label referring to the enclosed module. This exterior label can use wording such as the following: “Contains Transmitter Module FCC ID: XYZMODEL1” or “Contains FCC ID: XYZMODEL1.” Any similar wording that expresses the same meaning may be used. The Grantee may either provide such a label, an example of which must be included in the application for equipment authorization, or, must provide adequate instructions along with the module which explain this requirement. In the latter case, a copy of these instructions must be included in the application for equipment authorization. Please refer to the user manual instructions. 7. The modular transmitter must comply with any specific rule or operating requirements applicable to the transmitter and the manufacturer must provide adequate instructions along with the module to explain any such requirements. A copy of these instructions must be included in the application for equipment authorization. For example, there are very strict operational and timing requirements that must be met before a transmitter is authorized for operation under Section 15.231. For instance, data transmission is prohibited, except for operation under Section 15.231(e), in which case there are separate field strength level and timing requirements. Compliance with these requirements must be assured. The EUT is compliant with all applicable FCC rules. Detail instructions for maintaining compliance are given in the Users Manual. 8. The modular transmitter must comply with any applicable RF exposure requirements. For example, FCC Rules in Sections 2.1091, 2.1093 and specific Sections of Part 15, including 15.319(i), 15.407(f), 15.253(f) and 15.255(g), require that Unlicensed PCS, UNII and millimeter wave devices perform routine environmental evaluation for RF Exposure to demonstrate compliance. In addition, spread spectrum transmitters operating under Section 15.247 are required to address RF Exposure compliance in accordance with Section 15.247(b)(4). Modular transmitters approved under other Sections of Part 15, when necessary, may also need to address certain RF Exposure concerns, typically by providing specific installation and operating instructions for users, installers and other interested parties to ensure compliance. The EUT is compliant with all applicable RF exposure requirements. RF Exposure is addressed in the RF exposure exhibition. Note: If compliance with one or more of the numbered requirements, listed above, cannot be demonstrated, it may be possible to obtain a “Limited Modular Approval” (LMA). Name and surname of applicant (or authorized representative): TC Wu / Deputy Director (R & D Division) RF_734_00, Issue 1 Date: _Aug. 20, 2013___ Signature:

Report No.: 138091R-RFUSP29V01 Page : 1 of 5 Attachment 2 : EUT Detailed Photographs (1) EUT Photo (10 Pin) (2) EUT Photo (10 Pin) Report No.: 138091R-RFUSP29V01 Page : 2 of 5 (3) EUT Photo (14 Pin) (4) EUT Photo (14 Pin)

Lite-On Technology Corp. FCC ID.: PPQ-WB115C 4F,90,Chien 1 Road,Chung-Ho,Taipei Hsien 235,Taiwan,R.O.C..Tel : 886-2-2222-6181 The FCC ID Label will be placed on the equipment as shown in the photograph below.

Lite-On Technology Corp. FCC ID.: PPQ-WB115C 4F,90,Chien 1 Road,Chung-Ho,Taipei Hsien 235,Taiwan,R.O.C..Tel : 886-2-2222-6181 FCC ID Label

Report No.: 138091R-RFUSP29V01 Page : 3 of 5 (5) EUT Photo (10 Pin) (6) EUT Photo (10 Pin) Report No.: 138091R-RFUSP29V01 Page : 4 of 5 (7) EUT Photo (10 Pin) (8) EUT Photo (14 Pin) Report No.: 138091R-RFUSP29V01 Page : 5 of 5 (9) EUT Photo (14 Pin) (10) EUT Photo (14 Pin)

Report No. 138091R-RFUSP29V01 Page: 1 of 3 RF Exposure Evaluation declaration Product Name Bluetooth Module Model No. WB115C FCC ID PPQ-WB115C Applicant Lite-On Technology Corp. Address 4F, 90, Chien 1 Road, Chung Ho, New Taipei City 235, Taiwan, R.O.C. Date of Receipt Aug. 01, 2013 Date of Declaration Aug. 14, 2013 Report No. 138091R-RFUSP29V01 The declaration results relate only to the samples calculated. The declaration shall not be reproduced except in full without the written approval of QuieTek Corporation. This report must not be used to claim product endorsement by NVLAP any agency of the U.S. Government Report No. 138091R-RFUSP29V01 Page: 2 of 3 1. RF Exposure Evaluation 1.1. Limits According to FCC 1.1310: The criteria listed in the following table shall be used to evaluate the environment impact of human exposure to radio frequency (RF) radiation as specified in 1.1307(b) LIMITS FOR MAXIMUM PERMISSIBLE EXPOSURE (MPE) Frequency Range (MHz) Electric Field Strength (V/m) Magnetic Field Strength (A/m) Power Density (mW/cm 2 ) Average Time (Minutes) (A) Limits for Occupational/ Control Exposures 300-1500 -- -- F/300 6 1500-100,000 -- -- 5 6 (B) Limits for General Population/ Uncontrolled Exposures 300-1500 -- -- F/1500 6 1500-100,000 -- -- 1 30 F= Frequency in MHz Friis Formula Friis transmission formula: Pd = (Pout*G)/(4*pi*r 2 ) Where Pd = power density in mW/cm 2 Pout = output power to antenna in mW G = gain of antenna in linear scale Pi = 3.1416 R = distance between observation point and center of the radiator in cm Pd id the limit of MPE, 1 mW/cm 2 . If we know the maximum gain of the antenna and the total power input to the antenna, through the calculation, we will know the distance r where the MPE limit is reached. 1.2. Test Procedure Software provided by client enabled the EUT to transmit and receive data at lowest, middle and highest channel individually. The temperature and related humidity: 18°Cand 78％ RH. Report No. 138091R-RFUSP29V01 Page: 3 of 3 1.3. Test Result of RF Exposure Evaluation Product : Bluetooth Module Test Item : RF Exposure Evaluation Test Site : No.3 OATS Operation Frequency 2402 – 2480MHz Maximum Conducted output power 6.80dBm Antenna gain 0.45dBi Output Power Into Antenna & RF Exposure Evaluation Distance: Output Power to Antenna (mW) Power Density at R = 20 cm (mW/cm2) 4.7863 0.001056 Power density in column 4 is much lower than the limit (1 mW/cm 2 ).

Report No. 138091R-RFUSP29V01 Page: 1 of 110 FCC Test Report Product Name Bluetooth Module Model No. WB115C FCC ID. PPQ-WB115C Applicant Lite-On Technology Corp. Address 4F, 90, Chien 1 Road, Chung Ho, New Taipei City 235, Taiwan, R.O.C. Date of Receipt Aug. 01, 2013 Issued Date Aug. 14, 2012 Report No. 138091R-RFUSP29V01 Report Version V1.0 - The Test Results relate only to the samples tested. The test report shall not be reproduced except in full without the written approval of QuieTek Corporation. This report must not be used to claim product endorsement by TAF or any agency of the U.S. Government Report No. 138091R-RFUSP29V01 Page: 2 of 110 Test Report Certification Issued Date: Aug. 14, 2012 Report No.: 138091R-RFUSP29V01 Product Name Bluetooth Module Applicant Lite-On Technology Corp. Address 4F, 90, Chien 1 Road, Chung Ho, New Taipei City 235, Taiwan, R.O.C. Manufacturer Lite-On Technology (Changzhou) CO., LTD Model No. WB115C FCC ID. PPQ-WB115C EUT Rated Voltage DC 3.3V EUT Test Voltage AC 120V/60Hz Trade Name LITE-ON Applicable Standard FCC CFR Title 47 Part 15 Subpart C: 2012 ANSI C63.4: 2003, ANSI C63.10: 2009 Test Result Complied The Test Results relate only to the samples tested. The test report shall not be reproduced except in full without the written approval of QuieTek Corporation. This report must not be used to claim product endorsement by TAF or any agency of the U.S. Government Documented By : ( Senior Engineering Adm. Specialist / Anita Chou ) Tested By : ( Engineer / Alan Chen) Approved By : (Manager / Vincent Lin ) Report No. 138091R-RFUSP29V01 Page: 3 of 110 TABLE OF CONTENTS Description Page 1. GENERAL INFORMATION ...............................................................................................................5 1.1. EUT Description......................................................................................................................................5 1.2. Operational Description...........................................................................................................................8 1.3. Tested System Details..............................................................................................................................9 1.4. Configuration of Tested System ..............................................................................................................9 1.5. EUT Exercise Software ...........................................................................................................................9 1.6. Test Facility ...........................................................................................................................................10 2. CONDUCTED EMISSION ................................................................................................................ 11 2.1. Test Equipment ......................................................................................................................................11 2.2. Test Setup ..............................................................................................................................................11 2.3. Limits.....................................................................................................................................................12 2.4. Test Procedure .......................................................................................................................................12 2.5. Uncertainty ............................................................................................................................................12 2.6. Test Result of Conducted Emission .......................................................................................................13 3. PEAK POWER OUTPUT ..................................................................................................................21 3.1. Test Equipment ......................................................................................................................................21 3.2. Test Setup ..............................................................................................................................................21 3.3. Limit ......................................................................................................................................................21 3.4. Test Procedure .......................................................................................................................................21 3.5. Uncertainty ............................................................................................................................................21 3.6. Test Result of Peak Power Output .........................................................................................................22 4. RADIATED EMISSION .....................................................................................................................25 4.1. Test Equipment ......................................................................................................................................25 4.2. Test Setup ..............................................................................................................................................25 4.3. Limits.....................................................................................................................................................26 4.4. Test Procedure .......................................................................................................................................27 4.5. Uncertainty ............................................................................................................................................27 4.6. Test Result of Radiated Emission ..........................................................................................................28 5. RF ANTENNA CONDUCTED TEST .............…

Text truncated - open the document above for the full version.

Report No.: 138091R-RFUSP37V02 Page : 1 of 3 Attachment 1: EUT Test Setup Photographs Front View of Conducted Test Back View of Conducted Test Report No.: 138091R-RFUSP37V02 Page : 2 of 3 Front View of Radiated Test Back View of Radiated Test Report No.: 138091R-RFUSP37V02 Page : 3 of 3 Front View of Radiated Test (Horn) Back View of Radiated Test (Horn)